|
ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT
|
Facility
|
OP
|
$28,284.48
|
|
|
Service Code
|
CPT 28750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$28,284.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$28,284.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS, METACARPOPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;
|
Facility
|
OP
|
$28,284.48
|
|
|
Service Code
|
CPT 26850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$28,284.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$28,284.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 28730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; WITH OSTEOTOMY (EG, FLATFOOT CORRECTION)
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 28735
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT
|
Facility
|
OP
|
$28,284.48
|
|
|
Service Code
|
CPT 28740
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$28,284.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$28,284.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 28725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,795.33 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$7,795.33
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHRODESIS, WRIST; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 25810
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,339.76 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROEREISIS SUBTALAR 10mm
|
Facility
|
IP
|
$7,627.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2967911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,737.23 |
| Max. Negotiated Rate |
$7,016.84 |
| Rate for Payer: Aetna Commercial |
$6,864.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,559.22
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,042.31
|
| Rate for Payer: Cash Price |
$2,288.10
|
| Rate for Payer: Cigna Commercial |
$7,016.84
|
| Rate for Payer: Health EOS Commercial |
$6,788.03
|
| Rate for Payer: HFN Commercial |
$7,016.84
|
| Rate for Payer: Multiplan Commercial |
$6,101.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,576.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,016.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,737.23
|
| Rate for Payer: Quartz Commercial |
$4,576.20
|
| Rate for Payer: WEA Trust Commercial |
$4,194.85
|
| Rate for Payer: WPS Commercial |
$5,649.32
|
|
|
ARTHROEREISIS SUBTALAR 10mm
|
Facility
|
OP
|
$7,627.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
2967911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,135.56 |
| Max. Negotiated Rate |
$30,508.00 |
| Rate for Payer: Aetna Commercial |
$6,864.30
|
| Rate for Payer: Aetna Gatekeeper/Not Gatekeeper |
$6,559.22
|
| Rate for Payer: Aetna Managed Medicare |
$2,135.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$4,957.55
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$3,813.50
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$3,660.96
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO |
$4,042.31
|
| Rate for Payer: Cash Price |
$2,288.10
|
| Rate for Payer: Cigna Commercial |
$7,016.84
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$4,268.07
|
| Rate for Payer: Health EOS Commercial |
$6,788.03
|
| Rate for Payer: HFN Commercial |
$7,016.84
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$5,720.25
|
| Rate for Payer: Multiplan Commercial |
$6,101.60
|
| Rate for Payer: NAPHCARE Commercial |
$4,576.20
|
| Rate for Payer: Preferred Network Access Commercial |
$7,016.84
|
| Rate for Payer: Quartz Beloit One Network |
$3,737.23
|
| Rate for Payer: Quartz Commercial |
$4,957.55
|
| Rate for Payer: Quartz Medicare Advantage |
$4,576.20
|
| Rate for Payer: The Alliance Commercial |
$30,508.00
|
| Rate for Payer: WEA Trust Commercial |
$4,194.85
|
| Rate for Payer: WPS Commercial |
$5,649.32
|
|
|
ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHROPLASTY), WITH OR WITHOUT AUTOGRAFT OR ALLOGRAFT
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 27130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,452.00 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT
|
Facility
|
OP
|
$73,680.04
|
|
|
Service Code
|
CPT 24361
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,339.76 |
| Max. Negotiated Rate |
$73,680.04 |
| Rate for Payer: Aetna Managed Medicare |
$18,420.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$19,815.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,378.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,460.00
|
| Rate for Payer: Anthem Medicare Advantage |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,420.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,420.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,420.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68,522.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,420.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,420.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,420.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,420.01
|
| Rate for Payer: NAPHCARE Commercial |
$27,630.02
|
| Rate for Payer: Quartz Medicare Advantage |
$18,420.01
|
| Rate for Payer: The Alliance Commercial |
$73,680.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,420.01
|
| Rate for Payer: United Healthcare PPO |
$11,078.00
|
| Rate for Payer: Wellcare Medicare |
$18,420.01
|
|
|
ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACEMENT (EG, TOTAL SHOULDER))
|
Facility
|
OP
|
$73,680.04
|
|
|
Service Code
|
CPT 23472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,452.00 |
| Max. Negotiated Rate |
$73,680.04 |
| Rate for Payer: Aetna Managed Medicare |
$18,420.01
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$18,420.01
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$18,420.01
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$18,420.01
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$18,420.01
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$68,522.44
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$18,420.01
|
| Rate for Payer: Independent Care Health Plan Medicare |
$18,420.01
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$18,420.01
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$18,420.01
|
| Rate for Payer: NAPHCARE Commercial |
$27,630.02
|
| Rate for Payer: Quartz Medicare Advantage |
$18,420.01
|
| Rate for Payer: The Alliance Commercial |
$73,680.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,420.01
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$18,420.01
|
|
|
ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 25447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHOUT PATELLA RESURFACING (TOTAL KNEE ARTHROPLASTY)
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 27447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,596.00 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$11,874.87
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL OR LATERAL COMPARTMENT
|
Facility
|
OP
|
$52,034.24
|
|
|
Service Code
|
CPT 27446
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,339.76 |
| Max. Negotiated Rate |
$52,034.24 |
| Rate for Payer: Aetna Managed Medicare |
$13,008.56
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$18,649.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$18,649.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$17,230.00
|
| Rate for Payer: Anthem Medicare Advantage |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,008.56
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,008.56
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,008.56
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$8,339.76
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,008.56
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$48,391.84
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,008.56
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,008.56
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,008.56
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,008.56
|
| Rate for Payer: NAPHCARE Commercial |
$19,512.84
|
| Rate for Payer: Quartz Medicare Advantage |
$13,008.56
|
| Rate for Payer: The Alliance Commercial |
$52,034.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,008.56
|
| Rate for Payer: United Healthcare PPO |
$9,596.00
|
| Rate for Payer: Wellcare Medicare |
$13,008.56
|
|
|
ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION
|
Facility
|
OP
|
$28,284.48
|
|
|
Service Code
|
CPT 29888
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,071.12 |
| Max. Negotiated Rate |
$28,284.48 |
| Rate for Payer: Aetna Managed Medicare |
$7,071.12
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$17,483.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$16,081.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$15,278.00
|
| Rate for Payer: Anthem Medicare Advantage |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$7,071.12
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$7,071.12
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$7,071.12
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$7,071.12
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$26,304.57
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$7,071.12
|
| Rate for Payer: Independent Care Health Plan Medicare |
$7,071.12
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$7,071.12
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$7,071.12
|
| Rate for Payer: NAPHCARE Commercial |
$10,606.68
|
| Rate for Payer: Quartz Medicare Advantage |
$7,071.12
|
| Rate for Payer: The Alliance Commercial |
$28,284.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,071.12
|
| Rate for Payer: United Healthcare PPO |
$8,452.00
|
| Rate for Payer: Wellcare Medicare |
$7,071.12
|
|
|
ARTHROSCOPY
|
Facility
|
IP
|
$36,640.00
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$13,179.68 |
| Max. Negotiated Rate |
$36,640.00 |
| Rate for Payer: Aetna Managed Medicare |
$13,179.68
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$27,903.40
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$21,387.73
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$20,319.74
|
| Rate for Payer: Anthem Medicare Advantage |
$13,179.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$13,179.68
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$13,179.68
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$13,179.68
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$22,556.77
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$13,179.68
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$25,860.90
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$13,179.68
|
| Rate for Payer: Independent Care Health Plan Medicare |
$13,179.68
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$13,179.68
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$13,179.68
|
| Rate for Payer: NAPHCARE Commercial |
$19,769.52
|
| Rate for Payer: Quartz Medicare Advantage |
$13,179.68
|
| Rate for Payer: The Alliance Commercial |
$36,640.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13,179.68
|
| Rate for Payer: United Healthcare PPO |
$20,133.04
|
| Rate for Payer: Wellcare Medicare |
$13,179.68
|
|
|
ARTHROSCOPY, ANKLE, SURGICAL, EXCISION OF OSTEOCHONDRAL DEFECT OF TALUS AND/OR TIBIA, INCLUDING DRILLING OF THE DEFECT
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29891
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29898
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29897
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, KNEE, SURGICAL; ABRASION ARTHROPLASTY (INCLUDES CHONDROPLASTY WHERE NECESSARY) OR MULTIPLE DRILLING OR MICROFRACTURE
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY)
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29877
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICA OR SHELF RESECTION) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29875
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
|
ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, MAJOR, 2 OR MORE COMPARTMENTS (EG, MEDIAL OR LATERAL)
|
Facility
|
OP
|
$12,797.24
|
|
|
Service Code
|
CPT 29876
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,199.31 |
| Max. Negotiated Rate |
$12,797.24 |
| Rate for Payer: Aetna Managed Medicare |
$3,199.31
|
| Rate for Payer: Anthem Blue Access PPO/Blue Traditional |
$9,907.00
|
| Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus |
$8,043.00
|
| Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI |
$7,639.00
|
| Rate for Payer: Anthem Medicare Advantage |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO |
$3,199.31
|
| Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO |
$3,199.31
|
| Rate for Payer: Cook Children's Health Plan (CCHP) Commercial |
$3,199.31
|
| Rate for Payer: Dean Health DHI/DHP/ASO |
$9,884.08
|
| Rate for Payer: Dean Health Medicare Advantage/Medicare Select |
$3,199.31
|
| Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO |
$11,901.43
|
| Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO |
$3,199.31
|
| Rate for Payer: Independent Care Health Plan Medicare |
$3,199.31
|
| Rate for Payer: Managed Health Services Medicare Advantage |
$3,199.31
|
| Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace |
$3,199.31
|
| Rate for Payer: NAPHCARE Commercial |
$4,798.96
|
| Rate for Payer: Quartz Medicare Advantage |
$3,199.31
|
| Rate for Payer: The Alliance Commercial |
$12,797.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,199.31
|
| Rate for Payer: United Healthcare PPO |
$4,103.00
|
| Rate for Payer: Wellcare Medicare |
$3,199.31
|
|
